Reconsideration Specialist

Concentra, Inc.; Phoenix (AZ); On-site; USD 45,000 - 60,000; Full time

Benefits offered by this job

401(k) Retirement Plan with Employer M

Life & Disability Insurance

Paid Time Off & Extended Illness Days

Colleague Referral Bonus Program

Tuition Reimbursement

Dependent Care Spending Account

Employee Discounts

Job summary

Concentra, Inc. in Phoenix, AZ seeks a Central Billing Office Reconsideration Specialist to process billing adjustments and reconsideration payments in line with policies. This full-time role operates on 1st shift, Monday–Friday, with standard business hours at Sky Harbor Circle Phoenix.

You will work with payors, monitor reimbursements, and ensure accurate state reports and explanations of benefits. The position requires high school diploma and 1-3 years of medical billing experience, with

Qualifications

• High School Diploma or GED required; college degree preferred.
• Degree must be from an accredited college or university.

Responsibilities

• Communicates improper payments from payors
• Identifies and monitors incorrect reimbursement issues
• Identifies and applies appropriate adjustments per contracts/state requirements
• Processes and monitors all reconsiderations ensuring processing with the appropriate state reports, transcription, and explanation of benefits
• Follows-up on all previously sent reconsiderations for proper payment
• Processes short/zero payments for reconsiderations
• Communicates with CBO supervisor/manager regarding issues and resolution
• Performs other duties as assigned

Skills

Service mindset

Attention to detail

Sense of urgency

Initiative

Flexibility

Decision making

Customer service

HIPAA/PHI handling

CPT/ICD-9 coding

Problem solving

Organizational skills

Fast-paced environment

Research workers comp rules

Education

High School Diploma or GED

Degree from an accredited college or university

Job description

Are you looking for a career that transcends the ordinary? At Concentra, we offer opportunities beyond patient care. As a valued member of our team, you'll be part of our efforts to provide exceptional service to our employer clients and exceptional care to their employees. Our values define our path forward – always working to ensure welcoming, respectful, and skillful care. Join Concentra, and see what makes us different and better.

The Central Billing Office (CBO) Reconsideration Specialist performs a variety of basic tasks to moderately complex tasks to effectively process various billing adjustments and reconsideration payments according to Concentra and Central Billing Office policies and procedures.

• Employment Type: Full-time
• Schedule: 1st shift / standard business hours (Monday–Friday)
• Location: Sky Harbor Circle Phoenix, AZ

Employee Benefits

• 401(k) Retirement Plan with Employer Match
• Life & Disability Insurance
• Paid Time Off & Extended Illness Days Offered
• Colleague Referral Bonus Program
• Tuition Reimbursement
• Dependent Care Spending Account
• Employee Discounts

This job requires access to confidential and critical information, requiring ongoing discretion and secure information management.

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.

Concentra is an Equal Opportunity Employer, including disability/veterans

Concentra is an equal opportunity employer that prohibits discrimination, and will make decisions regarding employment opportunities, including hiring, promotion and advancement, without regard to the following characteristics: race, color, national origin, religious beliefs, sex (including pregnancy), age, disability, sexual orientation, gender identity, citizenship status, military status, marital status, genetic information, or any other basis protected by federal, state or local fair employment practice laws.

Responsibilities

• Communicates improper payments from payors
• Identifies and monitors incorrect reimbursement issues
• Identifies and applies appropriate adjustments per contracts or state requirements
• Processes and monitors all reconsiderations ensuring processing with the appropriate state reports, transcription, and explanation of benefits
• Follows-up on all previously sent reconsiderations for proper payment
• Processes short/zero payments for reconsiderations
• Communicates with CBO supervisor/manager regarding issues and resolution
• Performs other duties as assigned

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Qualifications

Education Level: High School Diploma or GED
Major: Degree must be from an accredited college or university.

Job-Related Experience

• 1- 3 years’ experience in medical billing or collections

Job-Related Skills/Competencies

• Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
• Ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions
• Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism
• The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies
• Working knowledge of medical CPT/ICD-9 coding
• Strong problem-solving skills
• Strong organizational skills
• Ability to work in fast-paced environment
• Strong attention to detailAbility to research workers compensation and coding rules
• Clear understanding of workers compensation reimbursement guidelines and regulations
• Ability to work independently
• Ability to assist peers and train new colleagues